To compare healthcare costs from the perspective of the Spanish National Healthcare System (NHS) of initiating treatment with pregabalin or SSRI/SNRI as add-on therapies in patients with generalized anxiety disorder (GAD), who are resistant to benzodiazepine-based therapy (BR).

BR patients with GAD (DSM-IV criteria) included in a prospective, multicentre, observational cohort study carried out in outpatients attending mental health centers, were selected in this post-hoc analysis. BR was defined as insufficient response with persistence of symptoms of anxiety (HAM-Anxiety scale≥ 16) after a 6-month course of BR (standard dose). Healthcare resource utilization (HRU) associated with GAD included drug treatments, medical visits, hospitalization and non-pharmacologic therapies which were collected twice (baseline and end-of-trial visits) during a 6-month period. Related costs were estimated in each visit and adjusted changes between visits compared using ANCOVA models.

A total of 128 patients received pregabalin and 126 SSRI/SNRI. Compared with SSRI/SNRI, pregabalin was associated with significantly lower adjusted mean increment use of anxiolytics; 0.55 vs. 1.12, p < 0.001, and greater reduction in medical visits; −15.12 vs.−12.99, p = 0.029. Mean adjusted healthcare costs were significantly decreased in both medication cohorts; −€;289: pregabalin (p = 0.003) and −€95 (p = 0.052) with SSRI/SNRI. Drug acquisition costs for SSRI/SNRI were lower than pregabalin, however adjusted healthcare cost reduction was numerically higher with pregabalin; −€289 versus −€194, p = 0.488.

Initiating treatment with pregabalin was associated with significant reduction in HRU and total cost for GAD compared to SSRI/SNRI in BR patients in the Spanish NHS setting.